Adolescent Friendly Health Clinics (AFHC)

Adolescent Friendly Health Clinics (AFHC)

1. Adolescent Friendly Health Clinics (AFHCs) State RMNCH+A Unit, J&K Tapas Chatterjee State Coordinator-RMNCH+A, J&K

2. Contents State RMNCH+A Unit, J&K Background Objective Infrastructure for AFHC Privacy of clinics Timing of AFHC Registration of Adolescent Outreach Activities Recording Reporting Mechanism Monitoring of AFHC

3. Several studies have shown that adolescents fail to access health services because of five key factors: L ack of knowledge about availability of services and means of access; S ocial and cultural deterrents; Perceived lack of privacy or confidentiality; Services are difficult to access i.e. too far way or too expensive; Staff appear to be unfriendly Background State RMNCH+A Unit, J&K

4. In this context, MoHFW launched Adolescent Health Strategy highlights the need for rolling out Adolescent Friendly Health Clinics (AFHC) across the country. The aim is to provide clinical and counselling services to adolescents through the existing health system. With a slight physical makeover, training of existing staff, introduction of a counsellor and provision of commodities, existing facilities would be equipped to provide adolescent friendly health services Background……………contd. State RMNCH+A Unit, J&K

5. Objective

6.   Infrastructure for an AFHC AFHCs should be characterised by two key factors : A warm and inviting space: The physical appearance of AFHCs is important for creating an environment where adolescents feel comfortable. A typical health set up might not attract adolescents, but a simple makeover with wall paint, colorful furniture, bright posters, LCD screens with appropriate health messages etc. can all transform the facility.   State RMNCH+A Unit, J&K

7. 2 . Privacy : Globally studies have shown that the two expectations that adolescents have from the services are that—a) they want to be treated with respect; and b) confidentiality is protected.   In this context, care should be taken to ensure that the AFHC is separate from the general OPD. Efforts should be made to maintain privacy and confidentiality, to ensure that adolescents are comfortable attending clinics.   Infrastructure for an AFHC State RMNCH+A Unit, J&K

8. There has to be a separate room for AFHC, in case of non availability of the separate room the available room should be sub divided to create space/room for the AFHC. The physical appearance of AFHCs is important for creating an environment where adolescents feel comfortable. Basic amenities like sitting arrangements, clean drinking water and clean toilets should be made available for the adolescents visiting the clinic   Infrastructure for an AFHC State RMNCH+A Unit, J&K

9. S No Items Quantity 1 Chair 3 2 Table 1 3 Curtains on doors and windows As per need 4 Bedside Screen 1 5 Almirah 1 6 Step Tool 1 7 Bench/Chair for waiting area As per need   Furniture State RMNCH+A Unit, J&K

10. S No Items Quantity 1 Weighing Machine 1 2 BP Apparatus 1 3 Stethoscope 1 4 Thermometer 1 5 Measuring tape 1 6 Torch/Flashlight 1 7 Snellen’s Chart 1 8 Height Chart 1   Equipment State RMNCH+A Unit, J&K

11. Efforts should be made to maintain privacy and confidentiality, to ensure that adolescents are comfortable attending clinics. Adolescents must be treated with dignity and respect. Place of physical examination must have screens. While examination of the adolescent girls ANMs/ LHVs must remain present. All the doors and windows of the Clinic must have curtains. Privacy of the Clients State RMNCH+A Unit, J&K

12. Timing of the Clinic SC PHC CHC DH Medical College Walk in Clinics by ANMs Weekly AFHCs from 2 to 4 p.m. by ANMs and MOs Daily AFHCs from 9 a.m. to 4 p.m. Dedicated AH Counselor Daily AFHCs from 9 a.m. to 4 p.m. Two-hour daily clinic from 2 to 4 p.m. by MOs, with support from ANMs   Specialty -AFHC with different specialties from 9 a.m. to 1 p.m. and Counselors from 9am to 4pm Two way role of the Counselor placed at CHC onwards to ensure on ground linkages with community through PE s and forward linkages with specialist in hospital , in case medical care is needed by adolescent client State RMNCH+A Unit, J&K

13. Registration of the Clients All the adolescents visiting the AFHCs must be registered and record must be maintained in the Client Registration Register. Referring all the adolescents coming to the General OPD to the AFHC must be avoided. Only those Adolescents who require counselling on specific AH issues should be referred to the AFHC. Adolescents requiring clinical services for general ailments or other diseases should be treated at the General OPD only. State RMNCH+A Unit, J&K

14. IEC The signboard of the clinic should be placed at a prominent place and it must have the logo of RKSK. AFHC services should be made a part of Citizen Charter of the facility . IEC material relevant to the Adolescent needs should be strategically displayed in AFHCs . Filip books, Pocket books, Pamphlet, posters to be utilized for communication . AFHC services should be widely publicized through Mid media and Mass media so that the beneficiaries and other stakeholders are aware of the services provided and understand the need for the same . State RMNCH+A Unit, J&K

15. Outreach Sessions Counsellor at AFHCs should prepare a tour plan for visiting Schools, Colleges, Youth Clubs, Major Health events, Adolescent Health Day etc. twice a week to sensitize the adolescents and the stakeholders . Major topics which can be covered during the outreach sessions are nutrition, puberty related concerns, Premarital Counselling, Sexual Problems, Contraceptive, Abortion, RTI/STI, Substance abuse, Learning problems, Stress, Depression, Suicidal Tendency, Violence, Sexual Abuse, Other Mental Health Issues, health lifestyle, risky behaviour etc . State RMNCH+A Unit, J&K

16. State RMNCH+A Unit, J&K Service Package DH CHC PHC SC Outreach   BMI screening √ √ √ √ √ Hb testing √ √ √ √ √ RTI/STI management √ √ √ √ √ ANC for pregnant adolescents √ √ √ √ √ Counselling on Nutrition, puberty related concerns,Premarital Counselling, Sexual Problems, Contraceptive, Abortion,  RTI/STI, Substance  abuse, Learning  problems, Stress, Depression, Suicidal Tendency,  Violence,  Sexual Abuse,  Other Mental Health Issues,  health lifestyle, risky behaviour √ √ √ √ √ Management of Menstrual problem √ √ √ √ √ Management of Iron deficiency Anaemia √ √ √ √   Screening for diabetes and hypertension √ √ √ √   Management of common adolescent health problems √ √ √ √   HIV testing and  counselling √ √       Management of physical violence and sexual abuse √ √       Linkages with de-addiction centres and referrals √ √       Treatment by specialists √ √       Referral √ √ √ √ √ Services

17. Types of registers Client Register Service Register Stock register Out Reach Register AFHC prescription Format Record Keeping State RMNCH+A Unit, J&K

18. AFHCs-CHC AFHCs-PHC AFHCs-DH District 3 rd of every month State Health Society AFHC wise monthly consolidated 5 th of every month Reporting Mechanism monthly consolidated reports State RMNCH+A Unit, J&K

19. Districts should regularly monitor and report on the following indicators to understand the functioning of AFHCs at each level:   Percentage and number of AFHC operationalised against planned (at PHC, CHC, DH) Client load at Adolescent Friendly Health Clinics per month (no.) Client referred from community to AFHC per month (no.) Percentage of adolescents accessing adolescent clinics for puberty-related problems, RTIs/STIs, mental health concerns, abortion care, nutrition Percentage and number of AH counsellors recruited against planned Total number of clients counselled Percentage and number of trained counsellors in place against planned Proportion of trained counsellors to total number of adolescents Percentage and number of MO trained in AFHS (male/female) against planned Percentage and number of ANMs/LHVs trained on AFHS against planned. Monitoring State RMNCH+A Unit, J&K

20. State RMNCH+A Unit, J&K THANK YOU